A Case of Bacteremia Due to Resistant Streptococcus pneumoniae

Streptococcus pneumoniae isolates with varying degrees of resistance to penicillin have been described. Strains that are highly resistant to penicillin (MIC,>1 Ag/mL) and that are resistant to multiple antibiotics have been reported primarily in South Africa and Spain. We report a case of an adult patient with bacteremia due to S. pneumoniae that was highly resistant to penicillin (MIC, 4 tig/mL) and resistant to erythromycin, clindamycin, chloramphenicol, and co-trimoxa-zole who was successfully treated with vancomycin. Infection with Streptococcus pneumoniae continues to be a significant cause of morbidity and mortality. Most of the pneumococci remain exquisitely sensitive to penicillin with MICs of <0.1 Ag/mL. However, S. pneumoniae with reduced susceptibility to penicillin (MIC ^ 1.0 ttg/mL) as well as to other antibiotics has been reported [1-3]. To our knowledge, we present the first case in the United States of an adult patient with bacteremia due to S. pneumoniae that was highly resistant to penicillin (MIC, 4 tig/mL) and many other antibi